(133) Drug Utilization of Paliperidone and Risperidone in Adolescent Schizophrenia Patients in China

Publication Number: 807

Background: Paliperidone and risperidone were approved for the treatment of adolescents (12-17 years) with schizophrenia by the China National Medical Products Administration (NMPA) in 2017 and 2019, respectively. It is important to characterize drug utilization in this population to ensure safe and appropriate use.

Objectives: To evaluate paliperidone and risperidone utilization in adolescents with schizophrenia in China.

Methods: We conducted a retrospective cohort study using electronic medical records (EMRs) from a general hospital (GH) (2018-2019) and a psychiatry specialized hospital (PH) (2018-2020) in China. Adolescent patients with a diagnosis of schizophrenia and who received at least one prescription of paliperidone or risperidone during the study period were included (risperidone prescriptions were identified after June 1, 2019, following approval). Patients exposed to paliperidone or risperidone formed two separate cohorts. Index dates were defined as the dates of the first identified paliperidone or risperidone prescriptions for each patient. Eligible patients were followed up until the end of the study, or upon reaching 18 years of age. Demographic characteristics prior to or at the index date and drug utilization during follow-up (e.g., treatment dose, duration) were characterized for each cohort.

Results: In the paliperidone cohort, 117 (mean age: 15.3y, male 45.3%) and 179 (mean age: 15.4y, male 48.6%) eligible patients were included from the GH and the PH databases, respectively. The median duration of use was 44.0 days and 35.5 days, respectively, during which the median number of prescriptions was 3.0 in both hospitals. Paliperidone was mostly initiated as monotherapy (88.9% and 64.3%) with frequency of once daily (88.9% and 83.8%), and the median average daily dose during follow-up was 6.0 mg/day and 5.5mg/day, respectively. In the risperidone cohort, 47 (mean age: 15.5y, male 66.0%) and 632 (mean age: 14.8y, male 44.9%) eligible patients were identified from the GH and the PH databases, respectively. The median duration of use was 61.0 days and 71.0 days, respectively, with median number of prescriptions of 2.0 and 3.0. Risperidone was also mostly initiated as monotherapy (78.7% and 69.5%), and about half prescriptions were once daily (53.2% and 48.7%). The median average daily dose was 1.6 mg/day and 2.2mg/day, respectively.

Conclusions: The mean age of adolescent schizophrenia patients receiving paliperidone and risperidone was both 15 years. Gender was similar in paliperidone users but somewhat different in risperidone users between the two hospitals. The dosages used were generally consistent with prescribing information.